Health anxiety disorders in older adults: Conceptualizing complex conditions in late life

Health anxiety disorders (e.g., hypochondriasis) are prevalent but understudied in older adults. Existing research suggests that severe health anxiety has a late age of onset, perhaps because of comorbidity with physical health conditions that are more likely to occur with aging. Despite being under...

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Bibliographic Details
Published in:Clinical psychology review 2013-12, Vol.33 (8), p.1096-1105
Main Authors: El-Gabalawy, R., Mackenzie, C.S., Thibodeau, M.A., Asmundson, G.J.G., Sareen, J.
Format: Article
Language:English
Subjects:
Age Factors
Aged
Aging - psychology
Anxiety Disorders - diagnosis
Anxiety Disorders - epidemiology
Diagnostic and Statistical Manual of Mental Disorders
Health anxiety
Health Status
Humans
Hypochondriasis
Hypochondriasis - diagnosis
Hypochondriasis - epidemiology
Older adults
Prevalence
Review
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Summary:Health anxiety disorders (e.g., hypochondriasis) are prevalent but understudied in older adults. Existing research suggests that severe health anxiety has a late age of onset, perhaps because of comorbidity with physical health conditions that are more likely to occur with aging. Despite being under diagnosed in later life due to a lack of age-appropriate diagnostic criteria, significant positive associations with age suggest that health anxiety disorders are more prevalent in older than younger adults. Preliminary research also highlights the complexity of these disorders in older adults and the potential importance of medical morbidity as a risk factor. This review explores the complexities of health anxiety disorders in later life with a focus on understanding defining features, prevalence rates, correlates, assessment, diagnosis, and treatment. We offer a theoretical model of the development of severe health anxiety among older adults to encourage further research on this important and under-studied topic. •Health anxiety disorders are misunderstood in late life.•Prior estimates of health anxiety disorders in older adults are underestimated.•Medical morbidity is a risk factor for severe health anxiety in late life.•Differentiation of disease conviction and adaptive health worry is essential.•Cognitive and behavioral features and reduced quality of life are indicators.
ISSN:0272-7358
1873-7811
DOI:10.1016/j.cpr.2013.08.010